Deep Anterior Lamellar Keratoplasty Versus Penetrating Keratoplasty: A Comparative Analysis Of Outcomes In Herpetic Keratitis
Published 2025 - 43rd Congress of the ESCRS
Reference: PO500 | Type: Free paper | DOI: 10.82333/vtkk-2458
Authors: Lars Christian Boberg-Ans* 1 , Daniel Hutter 2 , Morten La Cour 3 , Lars Konge 4 , Anton Le 3 , Andreas Arnold-Vangsted 1 , Ann Sofia Thomsen 3
1University Hospital of Southern Denmark, Vejle Hospital,Department of Ophthalmology,Vejle,Denmark, 2Voluntary Faculty,Bascom Palmer Eye Institute,Miami,United States, 3Department of Ophthalmology,Rigshospitalet-Glostrup,Glostrup,Denmark, 4Rigshospitalet, Copenhagen Academy for Medical Education and Simulation, ,Copenhagen,Denmark
Purpose
To evaluate graft survival, herpes recurrence and postoperative visual outcomes in patients undergoing partial penetrating keratoplasty (PPK) and deep anterior lamellar keratoplasty (DALK) for herpetic keratitis.
Setting
Retrospective study
Methods
Between January 2014 and March 2024, medical records of patients who underwent PPK and DALK surgery were retrospectively reviewed and 19 eyes of 19 patients with complete data were included in the study. Preoperative and postoperative uncorrected and corrected best visual acuity (VA), complete biomicroscopic examination findings, type of surgery, donor-related factors, the graft waiting period in storage medium after harvesting , graft endothelial count, type of suturing, additional ophthalmic diseases, post-transplant surgeries, complications, presence and treatment of herpetic recurrence, and graft rejection were recorded.
Results
7 eyes underwent DALK and 12 eyes underwent PPK. The mean age was 46.43± 5.74 years in the DALK group and 48.41± 6.25 years in the PPK group. Preoperative VA was 0.017±0.014 in DALK group and 0.0086±0.004 in PPK group and was statistically significant (p=0.024). Postoperative VA was 0.3±0.13 in DALK group and 0.087±0.04 in PPK group and was statistically significant (p=0.024). While no graft rejection was observed in the DALK group, graft rejection was recorded in 5 patients in the PPK group and was statistically significantly higher (p=0.047). Recurrence of herpetic keratitis was observed in 5 eyes in PPK group and 2 eyes in DALK group (p=474).
Conclusions
In our study, graft survival of DALK surgery was statistically significantly better than PPK in patients with herpetic keratitis. Although there was no statistical difference in terms of herpetic recurrence, it was noted that recurrence was much higher in the PPK group.